Prevalence of nontuberculous mycobacteria in water supplies of hemodialysis centers

Infection of hemodialysis patients with nontuberculous mycobacteria (NTM) has been associated with water used in reprocessing hemodialyzers. This study was conducted to determine the prevalence of NTM and other bacteria in water samples collected over a 13-week period from 115 randomly selected dialysis centers in the United States. Total viable counts were determined by membrane filter assays; increased recovery of NTM was obtained by dosing a portion of each water sample with 1% formaldehyde (HCHO) before filtering. NTM were widely distributed and occurred with a high frequency in water supplies in dialysis centers. NTM were detected in water from 95 centers (83%), and 50% of all samples examined contained NTM. The results of this study support recommendations to use 4% HCHO or a chemical germicidal equivalent for disinfecting dialyzers that are to be reused.

[1]  C. Woodley,et al.  Infections with Mycobacterium chelonei in patients receiving dialysis and using processed hemodialyzers. , 1985, The Journal of infectious diseases.

[2]  M. Alter,et al.  National surveillance of dialysis-associated hepatitis and other diseases. 1976 and 1980 , 1983 .

[3]  H. Ridgway,et al.  Adhesion of a Mycobacterium sp. to cellulose diacetate membranes used in reverse osmosis , 1984, Applied and environmental microbiology.

[4]  P. Falardeau,et al.  Mycobacterium Chelonei Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dial ysis (CAPD) , 1983 .

[5]  L. Bland,et al.  Efficacy of chemical dosing methods for isolating nontuberculous mycobacteria from water supplies of dialysis centers , 1988, Applied and environmental microbiology.

[6]  A. Hull,et al.  Probable Mycobacterium fortuitum septicemia: complication of home dialysis. , 1971, Lancet.

[7]  M. Favero,et al.  Factors That Influence Microbial Contamination of Fluids Associated with Hemodialysis Machines , 1974 .

[8]  Charles N. Haas,et al.  The ecology of acid‐fast organisms in water supply, treatment, and distribution systems , 1983 .

[9]  M. Favero,et al.  Gram-negative water bacteria in hemodialysis systems. , 1975, Health laboratory science.

[10]  R. Good,et al.  Peritonitis due to a mycobacterium chelonei-like organism associated with intermittent chronic peritoneal dialysis. , 1982, The Journal of infectious diseases.

[11]  L. Bland,et al.  Factors affecting endotoxin levels in fluids associated with hemodialysis procedures. , 1987, Progress in clinical and biological research.

[12]  R. Good,et al.  Spectrum of disease due to rapidly growing mycobacteria. , 1983, Reviews of infectious diseases.

[13]  M. Favero,et al.  Growth characteristics of atypical mycobacteria in water and their comparative resistance to disinfectants , 1978, Applied and environmental microbiology.

[14]  M. Alter,et al.  Hemodialyzer reuse: practices in the United States and implication for infection control. , 1985, Transactions - American Society for Artificial Internal Organs.

[15]  C. Goodman.  Association for the Advancement of Medical Instrumentation , 1988 .

[16]  B. Azadian,et al.  Disseminated infection with mycobacterium chelonei in a haemodialysis patient. , 1981, Tubercle.

[17]  R. Good,et al.  Identification of clinically significant Mycobacterium fortuitum complex isolates , 1981, Journal of clinical microbiology.

[18]  H. J. Kolmos.  Bacterial contamination of the blood compartment originating from the dialysate in haemodialysers. , 1984, The Journal of hospital infection.

[19]  Microbiologic guidelines for hemodialysis systems. , 1978, Health laboratory science.

[20]  M. Favero,et al.  Use of the Limulus amoebocyte lysate assay system for detection of bacterial endotoxin in fluids associated with hemodialysis procedures. , 1979, Progress in clinical and biological research.

[21]  P. Bretlau,et al.  Bacteriological Contamination of Dialyzers , 1978 .

[22]  M. Favero,et al.  Factors that influence microbial contamination of fluids associated with hemodialysis machines. , 1974, Applied microbiology.